Efficacy of Platelet-Rich Plasma in the Treatment of Fractures: A Meta-Analysis

Abstract

Background. Although numerous studies have reported the effectiveness of platelet-rich plasma (PRP) in promoting and enhancing bone healing, many orthopedic physicians remain skeptical of platelet-rich plasma in the treatment of fractures. The objective of this meta-analysis was to assess the efficacy of PRP in the treatment of fractures. Methods. We search for research on PRP treatment of fractures in Pubmed, Embase, Medline, and Cochrane libraries. Two independent reviewers assessed included studies and met to develop a consensus on included studies. We also assessed the risk of bias using Review Manager 5.3 software. Results. The present meta-analysis included 10 randomized controlled trials (RCT) containing 652 patients. In the fixed-effect meta-analysis of 10 RCTs, 8 RCTs found that fracture patients benefited from PRP treatment. The use of PRP reduced the time of fracture healing in 4 RCTs. Three RCTs found that PRP adjuvant therapy enhanced bone mineral density in the fracture trace and reduced the time of bone regeneration in mandibular fractures patients ( $\text{standardized}\text{mean}\text{difference}\left(\text{SMD}\right)=-1.99$ , $95\%\text{confidence}\text{interval}\left(\text{CI}\right)=-2.64–-1.35$ ). And 3 RCTs found that PRP adjuvant therapy decreased the risk of revision surgery in fracture patients ( $\text{SMD}=1.83$ , $95\%\text{CI}=1.10–3.04$ ). Conclusion. PRP adjuvant therapy is beneficial for the treatment of fracture patients, particularly those with mandibular fractures, and decreased the risk of revision surgery in fracture patients.